Prepaid Plans
Prepaid plans provide services through participating dentists throughout California. These plans are not available outside of California. You may change dentists upon request or change plans if you move and your plan is no longer available.
All prepaid dental plans have continuation of orthodontic care should you have this treatment in progress and you decide to change dental plans. Premier Access and Western Dental offer a dental implant benefit.
Monthly premiums for these
four prepaid plans are fully paid by the state. You have no monthly premiums,
deductibles, or maximum annual benefit limits. Many services are provided at low or no cost to
you. For more information on benefit coverage for these plans, please review
the Overview: Prepaid, Indemnity, and PPO Plans, and Coverage and Costs for Certain Procedures.
Before you enroll in a prepaid plan, first check with the plan to make sure it has participating dentists in your area. For more information or to obtain a list of each plan's participating dentists please call or visit the websites of the plans listed below:DeltaCare USA (800) 422-4234
MetLife* (800) 880-1800
Premier Access (888) 534-3466
Western Dental (866) 859-7525
You may also obtain a listing of the dentists in your area on the dental plan websites:
*Benefits provided by SafeGuard Health Plans, Inc., a MetLife company.
Delta Dental Plans
Delta Dental offers two plans: an indemnity plan
called Delta Dental PPO plus Premier Basic
and the Delta Dental Preferred Provider Option (PPO). If you enroll in either of these plans, you pay a monthly share
of the premium, which is deducted from your retirement warrant. Both plans are
summarized below. Additional details are available by contacting Delta Dental at (800) 225-3368 or visiting Delta Dental online at www.deltadentalins.com/state.
Delta Dental PPO plus Premier Basic
Delta Dental PPO plus Premier Basic features full access to specialty care and guaranteed benefits through in-network dentists. Your present dentist may be a member of Delta Dental PPO plus Premier Basic. It is to your advantage to select a contracted Delta Dental dentist. A lower percentage of the dentist's billed fees may be covered by this program if you select a dentist who does not contract with Delta Dental. However, you can see any dentist worldwide and still be covered.
Delta Dental dentists submit your treatment authorizations and claim forms to Delta Dental. If you receive services from a non-participating dentist, your reimbursement is based on the fee charged by that dentist or the fee that satisfies the majority of Delta Dental's participating dentists, whichever is less. If you live outside of California or the United States, you can be reimbursed by submitting either an itemized receipt or a standard claim form to Delta Dental. Reimbursement for services provided by a non-participating
provider will be paid directly to
you. Services provided by a non-participating provider may result in higher
out-of-pocket costs to you.
Delta Dental Preferred Provider Option (PPO)
The PPO provides higher benefit levels for you and your dependents when you receive services from a PPO provider. Your costs are based on a discounted fee agreement between Delta Dental and the PPO provider. This fee agreement will result in lower out-of-pocket costs to you when you visit a PPO network dentist. PPO network dentists submit your treatment authorizations and claim forms to Delta Dental. To locate a PPO dentist in your area, contact Delta Dental at (800) 225-3368 or visit Delta Dental online at www.deltadentalins.com/state.
Although you can receive services from any dentist worldwide, the PPO plan is not recommended if you are unable or unwilling to select a PPO network dentist. If you receive services from a Delta Dental dentist who is not a contracted PPO dentist, your coverage will be reduced and you will be responsible for the balance of fees. If you receive services from a dentist who is not a Delta Dental dentist, your reimbursement will be substantially lower. Any reimbursement for services provided by non-Delta Dental dentists will be paid directly to you.
